The present invention relates to a patient carestation, such as an infant carestation and, more particularly, to an apparatus having an integrated signal processing unit that receives disparate signals representing physiological information of a patient, such as an infant, as well as environmental conditions surrounding the infant being attended to by that infant care apparatus and/or other information relevant to the care of the infant.
Presently there are various differing types of patient care apparatus, particularly infant care apparatus, including incubators, warmers or combinations thereof. For example, an infant incubator is shown and described in U.S. Pat. No. 4,936,824 of Mackin et al; an infant warmer is shown and described in U.S. Pat. No. 5,474,517 of Falk et al and a combination apparatus combining the functions of an incubator and an infant warmer is shown and described in U.S. Pat. No. 6,224,532 of Jones et al and U.S. Pat. No. 6,231,499 of Jones et al.
With the use of such apparatus, it is typical to have certain sensors that detect various physiological conditions of the infant and the signals representative of those physiological conditions are sent to one or more monitors that provide a read out of that particular physiological condition. Typically, some of the physiological conditions are actually integrated into the infant care apparatus itself, such as patient skin temperature, where the skin temperature sensor is affixed to the infant and the signal representative of the infant skin temperature is directly sent to the infant care apparatus itself and normally used in a control algorithm to control the amount of heat provided to the infant.
There are other sensors, however, that also sense a particular physiological condition of the infant and those signals may or may not be integrated into some control or other circuitry within the infant care apparatus. More typically, such physiological sensors provide signals representative of a particular physiological condition via wires to a separate monitor where that condition is displayed and alarm functions are used to allow a continual visual display of the condition and activate an alarm if that condition exceeds certain norms. Accordingly, in order to carry out the monitoring of an infant, there may be numerous individual monitors and displays that are needed to enable the caregiver to continually have an overview of the well-being of the infant.
Within the normal hospital nursery, therefore, there are a vast number of monitors that receive data streams from sensors that sense, record and/or display the particular physiological condition sensed, and such physiological monitors can include sensors and monitors to sense and display weight, ECG, EEG, respiration, arterial blood pressure, non-invasive blood pressure, blood oxygenation, end tidal CO2 concentration, patient skin temperature, electronic images such as x-ray data, ultrasound, nmr and the like.
Each of those physiological sensors and monitors surround the infant care apparatus or are in close proximity thereto and which crowd the hospital nursery and make working conditions difficult with the myriad of wires, tubes and the like. It is difficult for the caregiver to take note of the different monitors located in separate locations in the nursery and the vast array of monitors creates a working environment that is cluttered with the inevitable wires and tubes to attach the various sensors to the monitors. The data from such physiological sensors generally is not seen by the infant care apparatus itself nor integrated with any other sensed signals even though one or more of such physiological monitors may be physically mounted to the infant apparatus.
In addition to sensors providing streams of data relating to some physiological condition of the infant, there are also normally present sensors that sense certain environmental conditions surrounding the infant, such as air temperature, O2 concentration and humidity.
The environment sensors sense conditions of the environment surrounding the infant, that is, the conditions that are normally created, in the most, by equipment that is affecting those conditions. Thus, the data from the environmental sensors may provide information that is somewhat, but not necessarily, indicative of the performance of the infant apparatus that is providing the support to the infant.
As a further type or classification of information or data that is of use in treating a patient, there is therapeutic data and which generally relates to certain peripheral equipment that may be providing some therapeutic treatment to the patient and which may include the use of a ventilator that is breathing for the patient, including the administration of inhaled nitric oxide, or an IV pump that is administering fluids to the patient. Therefore, the therapeutic data includes information relating to that peripheral equipment and may include, for example, airway pressure, airway flow, tidal volume, partial pressure of gases inhaled and drip rate, identity and concentration of fluids being administered and the like.
An additional type or class of information or data that is used in the care of a patient is basically the patient information, such as medical history, pharmalogical information and the like and such information relates to the patient and may be inputted at the patient location by a caregiver or remotely provided by some central data base, such as the hospital central data system. Typically, the patient information can include the patient history, lab data from the analysis of patient fluids such as CBC, bilirubin, electrolytes, hematocrit, as well as information relating to allergies, prior treatment, drugs administered, current treatment, therapy administered, risk/history data, clinical findings and the like.
Not only is the number and type of monitors and inputs for physiological conditions, environmental conditions, therapeutic conditions and patient information of the infant varied, but the signals themselves may also be varied, that is, some of the electronic signals may be in digital form, others in analog form and some may be coded to the particular monitor so that all of the signals are not of a common type or stream of electronic data.
There has been, in the past, an infant care apparatus that received, from separate transducers, signals representative of the patient's skin temperature and the concentration of oxyhemoglobin in the infant's blood via oximetry, and provided those signals in a stream of data at an outlet of the infant care apparatus, for instance at an RS232 plug, however, even with that infant care apparatus, the environment surrounding the infant was not taken into consideration and which can be affected by the performance and functioning of the infant care apparatus itself or by some peripheral equipment. In addition, while the information and data may have been available, there was no attempt to make use of the combined information and data to enhance the quality of care being provided to the infant.
Other apparatus have individually sensed one physiological condition of an infant i.e. the skin temperature and one environmental parameter indicative of the performance of an infant care apparatus i.e., air temperature, however, there has been no attempt to combine the stream of electronic signals from a plurality of physiological sensors, other than patient skin temperature, with a stream of electronic signals from at least one environmental parameter sensor, or other information inputs into a unified, integrated stream of information in electronic form and to make use of the diverse information that is thereby available in that combination of electronic signals despite a clear need and use for the combined stream of data and information.
Thus, in effect, there are streams of data relating to the environment of the infant, the physiological condition of the infant, therapeutic data and patient data however those streams of data are maintained separate and go off in a variety of directions from the infant care apparatus to separate monitors or to some storage location and, therefore, provide only a partial, somewhat disjointed picture of the function and operation of the apparatus as well as the wellbeing of the infant since the caregiver cannot see the overall picture by having all of the relevant data and information available at one convenient location.
As such there are, therefore, a myriad of monitors and sensors that continuously ascertain the various types or classes of data and information relating to the patient, distributed in various locations about the nursery or other hospital location, however, there has been no attempt to combine the disparate signals into an integrated stream of data and to use the integrated stream of data in a form that is compatible in order to evaluate the infant or the apparatus, or both. Without that central integration circuitry that can process the various signals that carry data and information from the differing sensors and inputs to a integrated signal processor, there is, obviously, no way that a user can gain the important insight that can be derived from utilizing all of the various types of data and information to evaluate the apparatus and/or the infant.
For example, the combined data and information from an infant incubator environmental conditions and physiological information for an infant can be used as a confirmation of various multiple signals to allow faster clinical actions and less clinical errors to be determined by providing integrated steps or data representative of both the physiological information as to the patient and the environmental information relating to certain parameters of the apparatus. That information can, in integrated form, be used to glean considerably more information than with the present situation where the individual signals from each different sensor are individually used in multiple monitors that may not even be proximate to each other.
As an example, information from a physiological sensor, such as an ECG sensor can provide data as to the heart rate of the patient, evidence typically associated with determining bradycardia, and the information from a therapeutic sensor relating to the airway pressure of a ventilator can also be obtained and which may show a lower inspiratory pressure than the set pressure, thus by having the combination of information available by an integrated stream of data and information, the data can be assimilated by a signal processor in, for example, an infant care center, to interpret that data and flash a message to the clinician to check the ventilator for a malfunction, leak or a partial detachment from the patient airway. Individually, at the present, those different sensed values are located at separate, spaced apart monitors may not allow the clinician to respond as rapidly.
As a further example, the patient skin temperature, normally a item of information or data available at the infant care apparatus, can provide an indication that the patient skin temperature is descending and which is another symptom of bradycardia and it would also be advantageous to have that data and information available in an integrated stream of information and data for use by the clinician or other circuitry to interpret the data so as to be available to the clinician in a visually perceptible means for the clinician or by a signal processor or the like to interpret and use the various data and information.
Thus, it would be advantageous to have some means of integrating data relating to a plurality of differing modalities, that is, at least two physiological conditions of the infant, where those physiological conditions are some conditions other than infant skin temperature, the data relating to the environment surrounding the infant, the data indicative of the therapy provided by peripheral equipment and information relating to the patient at one location and to provide signal processing at that location on or built into an infant carestation to be able to process all of the available data in the signals from the variety of sensors and inputs and integrate all of that incoming data into a united, centrally located stream of data that can be used in various ways, including in a monitor that provides a visual perceptible indication of that integrated information that is of use to the caregiver.
It would therefore be advantageous in such infant carestation that there be some means to integrate all of the disparate signals from a myriad of individual sensors, including a plurality of sensors that sense physiological information of the patient, other than patient skin temperature, as well as at least one environmental condition such as a performance parameter of the infant care apparatus or other information in order to have a integrated, usable stream of information and data representative of the environmental and physiological conditions of the infant as well as patient data and therapeutic data.
It would be further advantageous in an infant carestation to have some diagnostic apparatus that can actually interpret the aforementioned diverse data and information to provide better care for the infant, whether in a more accurate diagnosis of a problem with the infant or the equipment assisting the infant or in providing a faster analysis of the conditions of the infant or the equipment in order to better care for the wellbeing of that infant or equipment.